Arterial color Doppler ultrasonography

Furuse, J., Maru, Y., Yoshino, M., Mera, K., Suml, H., Seklgnchl, R., Sataka, M., Hasebe, T., Ochlal, A. Assessment of arterial tumor vascularity in small hepatocellular carcinoma. Comparison between color Doppler ultrasonography and radiographic imagings with contrast medium dynamic CT, angiography, and CT hepatic arteriography. Eur. J. Radiol. 2000 36 20-27... 

Variations in penile arterial anatomy are observed in up to 83% of patients (Jarow et al. 1993) and are commonly recognized at color Doppler ultrasonography (Chiou et al. 1999). Power Doppler investigation can be useful to improve depiction of small vessels with slow flow. 

Fig. 6.16. Transversal scan. Color Doppler image showing flow inversion in the left cavernosal artery (arrowhead) consistent with arterial obstruction and retrograde recanalization. (Reprinted with permission from Bertolotto M, Gasparini C, Calderan L, Lissiani A, Cova MA (2005) Color Doppler ultrasonography of the penis state of the art. Gior-nale Italiano di Ecografia 8 113-127)...

Although alteration of the venous occlusive mechanism has been claimed to be present in a high percent of Peyronie s patients with erectile dysfunction (Weidner et al. 1997), the role of arterial inflow must be investigated. In fact, color Doppler ultrasonography shows associated arterial insufficiency in 30%-50% of these patients (Kadioglu et... 

Direct identification of the arterial-lacunar fistula is obtained with Doppler techniques. Color Doppler ultrasonography allows identification of the lesion in virtually all patients only one case has been reported in which the fistula was not detected both at color Doppler and at angiography, but became evident only after empiric selective embolization of the contralateral internal pudendal artery (Ankem et al. 2001). 

Besides identification of the arterial-lacunar fistula, color Doppler ultrasonography allows evaluation of the penile vasculature to identify hemodynamically significant feeding vessels that present with high velocity flow. Both unilateral and bilateral feeding... 

During the follow-up of high-flow priapism, magnetic resonance imaging is able to document persistent closure or recanalization of the embolized cavernosal artery (Park et al. 2001). Color Doppler ultrasonography, however, usually provides enough clinically useful information in these patients. 

In patients undergoing vascular surgery for impotence, preoperative color Doppler ultrasonography is indicated to evaluate cavernosal arterial flows and to assess penile vascular anatomy, with concern for size of the dorsal arteries, for presence of anatomic variations and for collateral arterial vascular pathways (Bertolotto et al. 2005). 

After the operation, color Doppler ultrasonography allows evaluation of the postoperative vascular anatomy and of blood flow characteristics (Bertolotto et al. 2005). In patients with arterial revascularization, retrograde or anterograde arterial flow is recorded in the dorsal artery, depending on the surgical procedure (Fig. 16.6, Fig. 16.7). The... 

In patients with diffuse cavernosal fibrosis associated with severe impairment of the cavernosal artery inflow, small peripheral vessels can be demonstrated at color Doppler ultrasonography feeding the outer portions of the corpora cavernosa through small collaterals from extraalbugineal vessels (Fig. 18.7). 

Grey-scale and color Doppler ultrasonography characteristically show widespread calcification (Fig. 20.7) of the tunica albuginea, of the cavernosal arteries and obliteration of the distal segments of the penile vessels. In patients with severe presentation, the entire penile vascular tree maybe calcified. Small calcifications can be occasionally identified within the cavernosal tissue as well. 

Sarteschi LM, Montorsi F, Fabris FM et al (1998) Cavernous arterial and arteriolar circulation in patients with erectile dysfunction a power Doppler study. J Urol 159 428-432 Shabsigh R, Fishman IJ, Quesada ET et al (1989) Evaluation of vasculogenic erectile impotence using penile duplex ultrasonography. J Urol 142 1469-1474 Tam PY, Keller T, Poppiti R et al (1998) Hemodynamic effects of transurethral alprostadil measured by color duplex ultrasonography in men with erectile dysfunction. J Urol 160 1321-1324... 

In patients with corporeal plication ultrasonography shows small lumps next to the albugineal sutures extending within the corpora cavernosa (Bertolotto et al. 2005). In patients with normal erection before surgery after shortening procedures, postoperative erectile dysfunction is uncommon. When present, color Doppler interrogation allows evaluation of the penile arteries and identification of leakage pathways. 

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